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Do Initial Trunk Impairment, Age, Intervention Onset, and Training Volume Modulate the Effectiveness of Additional Trunk Exercise Programs after Stroke? A Systematic Review with Meta-Analyses

1
Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, 03202 Elche, Spain
2
Infectious Diseases Unit, Hospital General Universitario de Elche, Miguel Hernández University of Elche, 03203 Elche, Spain
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(23), 8714; https://doi.org/10.3390/ijerph17238714
Received: 13 October 2020 / Revised: 15 November 2020 / Accepted: 19 November 2020 / Published: 24 November 2020
(This article belongs to the Section Exercise and Health)
The aim of this systematic review is to analyze how, after additional trunk-focused training programs (ATEP), motor recovery after a stroke is modulated by potential effect modifiers. Twenty randomized controlled studies that carried out ATEP were included. Results showed moderate-to-high effects in favor of ATEP for trunk function, balance ability, gait performance, and functional mobility. Studies with a higher initial trunk impairment obtained a higher effect on trunk function and balance; studies with older participants had a higher effect on trunk function, limit of stability, and functional mobility, but not on balance ability. Older and more affected patients were, as well, those who started the intervention earlier, which was also linked with higher effects on trunk function, balance, and gait performance. Longer ATEP found a high effect on trunk function and balance ability. The potential effect modifiers seem to be important in the modulation of the effectiveness of ATEP and should be considered in the design of rehabilitation programs. Thus, since potential effect modifiers seem to modulate ATEP effectiveness, future studies should consider them in their experimental designs to better understand their impact on stroke rehabilitation. View Full-Text
Keywords: core stability; rehabilitation; moderator core stability; rehabilitation; moderator
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    Doi: 10.5281/zenodo.4086086
    Description: Supplementary Materials: The following are available online at www.mdpi.com/xxx/s1, Figure S1: Pooled effect sizes on trunk function; Figure S2: Pooled effect sizes on balance ability; Figure S3: Pooled effect sizes on limits of stability; Figure S4: Pooled effect sizes on gait performance; Figure S5: Pooled effect sizes on functional mobility; Figure S6:Subgroup analyses by initial trunk impairment; Figure S7: Subgroup analyses by participants’ age; Figure S8: Subgroup analyses by the start of the intervention after the stroke-onset; Figure S9: Subgroup analyses by total volume (minutes) of the additional trunk exercise programs, Table S1: Boolean search strategy for each database; Table S2: PEDro scale to assess methodological quality; Table S3: Quality of evidence (GRADE approach) between additional trunk-focused exercises vs conventional rehabilitation; Table S4: PRISMA checklist.
MDPI and ACS Style

Prat-Luri, A.; Moreno-Navarro, P.; García, J.A.; Barbado, D.; Vera-Garcia, F.J.; Elvira, J.L.L. Do Initial Trunk Impairment, Age, Intervention Onset, and Training Volume Modulate the Effectiveness of Additional Trunk Exercise Programs after Stroke? A Systematic Review with Meta-Analyses. Int. J. Environ. Res. Public Health 2020, 17, 8714. https://doi.org/10.3390/ijerph17238714

AMA Style

Prat-Luri A, Moreno-Navarro P, García JA, Barbado D, Vera-Garcia FJ, Elvira JLL. Do Initial Trunk Impairment, Age, Intervention Onset, and Training Volume Modulate the Effectiveness of Additional Trunk Exercise Programs after Stroke? A Systematic Review with Meta-Analyses. International Journal of Environmental Research and Public Health. 2020; 17(23):8714. https://doi.org/10.3390/ijerph17238714

Chicago/Turabian Style

Prat-Luri, Amaya; Moreno-Navarro, Pedro; García, Jose A.; Barbado, David; Vera-Garcia, Francisco J.; Elvira, Jose L.L. 2020. "Do Initial Trunk Impairment, Age, Intervention Onset, and Training Volume Modulate the Effectiveness of Additional Trunk Exercise Programs after Stroke? A Systematic Review with Meta-Analyses" Int. J. Environ. Res. Public Health 17, no. 23: 8714. https://doi.org/10.3390/ijerph17238714

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